Literature Review

Man pleads guilty in connection with $17m Medicare hospice fraud and home health care fraud schemes Office of Public Affairs - U.S. Department of Justice; Press Release; 2/3/25A California man pleaded guilty today to health care fraud, aggravated identity theft, and money laundering in connection with a years-long scheme to defraud Medicare of more than $17 million through sham hospice companies and his home health care company. According to court documents, Petros Fichidzhyan, 43, of Granada Hills, engaged in a scheme with others to operate a series of sham hospice companies. Fichidzhyan, along with co-schemers, impersonated the identities of foreign nationals to use as the purported owners of the hospices — including using the identities to open bank accounts and sign property leases — and submitted false and fraudulent claims to Medicare for hospice services that were not medically necessary and not provided. In submitting the false claims, Fichidzhyan and his co-schemers also misappropriated the identifying information of doctors ... [Click on the title's link to continue reading.]

Polsinelli attorney: Expand access to capital for hospice, health care providersHospice News - Executive Perspectives; by Jim Parker; 1/28/25 Private equity in health care has come under fire in recent years, but the regulatory environment leaves few other options for raising capital. This is according to Bobby Guy, an M&A attorney and shareholder in the law firm Polsinelli. Guy posits that regulation of publicly traded markets have pushed business owners towards private equity and reduced transparency when it comes to corporate funding. ... The question should not be whether PE is good or bad for health care. The question should be, “How are we going to fund health care?” That’s the real question.Editor's note: This is an "Executive Perspective." Adding another perspective, I invite you to apply this proposed "real question" across the board to all potential payment sources. Are fraud and abuse payments ok, as long as they pay the bills? When you are dying--whether in hospice or not--will the quality of health care you receive matter? If the hospice patient is your child, your spouse, your parent, does the "good or bad" of the health care provided matter? I do not determine the answers for you. I re-ask the question, inviting readers to examine (1) the core purposes and values of hospice care and (2) its expansive body of clinical research data. 

Hospice rationale should be reassessed, says ethicist Medscape; by Arthur L. Caplan, PhD, Medical Ethics at NYU’s Grossman School of Medicine; 1/23/25 ... Decades ago, I first found out about the idea that came from England and a nurse, Cicely Saunders, to change the setting in which people die. ... I think that was a wonderful idea, and it has revolutionized end-of-life care. We have many excellent, superb hospice programs. ... The hospice institution is decades old, and it’s time to take another look at what’s going on there.  ... Private equity is all over this area, buying up hospice chains and home care hospice — looking to make big profits but not looking to maintain the quality requirements that ought to be there or to do more than is minimally required to set up and staff hospice. ... ... For reasons of serving the best interests of hospice patients, we should be rechecking the fairness of reimbursement, not overburdening families with care that ought to be provided by hospice programs, and making sure that those who are dying are monitored adequately and receiving checkups regularly. ...

Covenant Homecare and Hospice launches partnership with Care Coordinations to enhance communications and patient engagement East Coastsentinel, Knoxville, TN; Press Release, Shawn Zbranek; 1/20/25 Covenant HomeCare and Hospice, ... home health and hospice services in East Tennessee, announced a cutting-edge partnership with Care Coordinations, a company which provides technology solutions to enhance post-acute care. Care Coordinations and Covenant HomeCare are creating new communications functionality within HomeCare HomeBase SM (HCHB), the electronic medical record (EMR) used by Covenant HomeCare. The Care Coordinations platform will consolidate multiple communication channels, enhance patient engagement, and significantly streamline clinical operations.

Federal report highlights private equity, consolidation concerns Modern Healthcare; by Hayley Desliva; 1/16/25 Three federal agencies on [1/15/25] said "more effective and vigorous" enforcement is needed to protect patients harmed by healthcare's continued consolidation. In a report released just days before a new administration takes over, the Health and Human Services Department, Federal Trade Commission and Justice Department said comments they sought earlier this year on the state of the industry made clear that worries about access to services and costs have intensified as consolidation and private equity's role have grown. ... The report noted several areas of concern: 

VITAS eyeing expansion in 12 states Hospice News; by Jim Parker; 1/14/25 Historically, VITAS Healthcare has relied heavily on organic growth, a strategy the company is not turning away from. However, it may add more acquisitions to the mix. VITAS is a subsidiary of Chemed Corp. (NYSE: CHE). The company this year made its return to the M&A market after a hiatus of several years. In April, VITAS acquired Covenant Health and Community Services’ hospice operations as well as one assisted living facility in an $85 million deal. Now, the company is seeking out other targets, with an emphasis on Certificate of Need states. “There are at a minimum 12 states we don’t operate in that we think are very attractive to us, and we are out actively sourcing deals, and we expect some of that deal flow to continue to come through here in 2025 and beyond …” VITAS CEO and Chairman Nick Westfall said during the JP Morgan Healthcare conference. “We think we’re in the early roads of really an ongoing consolidation inside of the space.”

Prospect Home Health and Hospice, LLC bankruptcy filing BankruptcyObserver.com; Case Number 25-80011; 1/13/25 The bankruptcy petition for Prospect Home Health and Hospice, LLC [Northern District of Texas bankruptcy cour] showed assets in the range of more than $1B with liabilities in the range of more than $1B. Prospect Home Health and Hospice, LLC reports that the number of creditors is in the range of more than 100,000.

Healthcare Private Equity Outlook & Trends - January 2025JD Supra; by Emily Burrows, David Cox, Michael Dashefsky, Lara Flatau, Tabitha Green, Anna Grizzle, Angela Humphreys, Stewart Kameen, Travis Lloyd, Jennifer Michael, Lucas Ross Smith, Jonathan Stanley, Ryan Thomas, Nesrin Garan Tift, Shannon Wiley, Roy Wyman, Patrick Zinck; 1/10/25 As some packed the skis and headed to their favorite slopes this winter season, it is hard not to see the analogies to the healthcare private equity (PE) transaction market as we ring in the New Year. Much like the Northern Rockies, there should be plenty of dry powder to support a robust dealmaking environment in 2025. ... [From its attached PDF]

Amedisys halts sale of home health, hospice locations to VitalCaring Hospice News; by Holly Vossel; 1/7/25 Amedisys’ (Nasdaq: AMED) has halted the divestiture of some of its home health and hospice locations to Texas-based VitalCaring. Amedisys in June announced an agreement to sell some of its locations to the private equity-backed home health and hospice provider VitalCaring. ... The news to cancel the divestiture comes after a recent court order issued by a federal judge in Delaware requiring that VitalCaring allocate 43% of future profits to Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). [Click on the title's link to continue reading.]

Ascension Living residents, employees among 6 million affected by data breach McKnights Senior Living; by Kathleen Steele Gaivin; 1/6/24 Senior living and care residents and employees are among the six million people Ascension said Dec. 19 that it was notifying of potential stolen personal information in the wake of a May 8 ransomware attack. The St. Louis-based nonprofit healthcare network, which includes Ascension Living, operator of three dozen senior living and care communities and also a provider of home care and hospice services, announced Dec. 19 that a review by third-party experts of the attack was complete. On that date, Ascension began notifying individuals whose personal information was involved and is providing them with free credit monitoring and identity protection services.

Now open: VITAS Healthcare inpatient hospice unit in Fort Worth South Florida Hospital News and Healthcare Report; by cfelixcpa; 1/3/25Easier access to compassionate end-of-life care is now available for patients and families in Fort Worth and surrounding communities. The new freestanding VITAS Healthcare Inpatient Hospice Unit (IPU), located within five miles of the medical district, provides high-quality hospice services in a homelike environment for patients nearing the end of life. The IPU is expected to care for more than 500 patients each year, particularly those whose pain and symptoms cannot be managed effectively at home. A grand opening celebration was held to commemorate the addition to the Fort Worth community. 

UnitedHealth Group waives deadlines to complete $3.3B home health acquisition The MInnesota Star Tribune; by Brooks Johnson; 12/27/24 UnitedHealth Group has filed for more time to complete a $3.3 billion deal to buy Amedisys, a home health care and hospice company, after the companies agreed to waive deadlines in the face of antitrust scrutiny. The U.S. Department of Justice and several states last month sued to block the deal, alleging the merger would give the Minnetonka-based health care conglomerate a commanding stake in many areas. “ ... UnitedHealth and Amedisis agreed to waive two deadlines to complete the deal, according to a Securities and Exchange Commission document filed Friday. One would have given 10 days after a court ruling to complete the deal; the other gave the companies until the end of 2025. UnitedHealth will now have to pay $275 million if the company backs out of the deal, a $25 million increase, and that figure could rise to $325 million.

Providence’s joint venture with Compassus likely delayed amid concerns about patient care and rural access Home Health Care News; by Audri Martin; 12/19/24Oregon’s Health Care Market Oversight (HCMO) program is reviewing a proposal to spin off Providence’s home health and hospice services into a joint venture supported by private equity. ... OHA’s HCMO program evaluates health care business transactions to ensure they do not negatively impact citizens or communities. The program also empowers state regulators to impose conditions on acquisitions and mergers or reject deals they find anti-competitive. Critics of the deal argue that the joint venture will result in cost-cutting measures, increased staff workloads and reduced patient services. Providence is the fifth largest nonprofit health care provider in the United States, while Compassus is a private equity-backed provider of home-based care services operating in more than 30 states.